Healthcare Provider Details

I. General information

NPI: 1538350764
Provider Name (Legal Business Name): FAMILYFIRSTPEDIATRICS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8714 SPRING CYPRESS RD STE 170
SPRING TX
77379-3396
US

IV. Provider business mailing address

515 W GREENS RD
HOUSTON TX
77067-4531
US

V. Phone/Fax

Practice location:
  • Phone: 281-374-8882
  • Fax: 281-374-8886
Mailing address:
  • Phone: 281-872-1614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TAD MICHAEL SHIRLEY
Title or Position: PRESIDENT
Credential: MD
Phone: 281-374-8882